The prevalence of neuropathy among those with diabetes has been estimated to be as high as 50%. Painful diabetic neuropathy (PDN), which tends to affect the feet and legs, has been estimated to affect roughly 16% to 20% of the more than 25 million people in the United States who are living with diabetes. The condition often goes unreported and even more are untreated, with an estimated 40% of patients not receiving care for PDN. A Need for Guidance for Diabetic Neuropathy “Painful diabetic neuropathy is a big problem for all healthcare providers who treat patients with diabetes,” says John D. England, MD, FAAN. “There are increasingly more drugs being developed and brought to market that can be used for treating diabetic neuropathy. For a busy practitioner, it’s often difficult to keep up with all of the new evidence and to decide what a rational, tiered approach should be to treatment.” Part of the issue is the volume of literature on the topic. In 2007, when members of the American Academy of Neurology (AAN) felt there was a need to update guidelines for the treatment of PDN, the process started with more than 2,200 papers. Of them, 463 were deemed relevant and 79 were highly pertinent to the guidelines. Since then, many more studies have emerged. Physicians should refer to the AAN guidelines to learn which drugs have the best scientific evidence supporting their use to treat PDN. — John D. England, MD, FAAN In the May 17, 2011 issue of Neurology, the AAN published its first evidence-based guidelines on use of a range of pharmacologic and non-pharmacologic treatments...